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1417708520
BENJAMIN STEVAN VANTASEL
NORFOLK, VA
NPI
1417708520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-27
Last Update Date
2024-03-27
Business Address
BENJAMIN STEVAN VANTASEL DO
600 GRESHAM DR STE 100
NORFOLK, VA 23507-1904
Phone number: 757-388-6200
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Mailing Address
BENJAMIN STEVAN VANTASEL DO
103 E MEADOWLARK ST
KILL DEVIL HILLS, NC 27948-9174
Phone number:
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